Individual
HARRY K. MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
717 SE 2ND ST, FT LAUDERDALE, FL 33301-3605
(954) 493-5005
(954) 337-3309
Mailing address
717 SE 2ND ST, FT LAUDERDALE, FL 33301-3605
(954) 357-1172
(954) 337-3309
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME51849
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04903
BLUECROSSBLUESHIELD OF FL
FL
Enumeration date
12/12/2006
Last updated
01/22/2014
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